Yang Xinyun, Lin Tongtong, Luo Lina, Chen Hao, Dai Yifei, Li Dingheng, Zhu Linling
Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Gynecology, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
Gynecol Endocrinol. 2025 Dec;41(1):2487498. doi: 10.1080/09513590.2025.2487498. Epub 2025 Apr 4.
To date, there remains a paucity of prospective studies examining the association between premature ovarian insufficiency (POI) and cardiovascular diseases (CVD). The objective of this study was to investigate the potential association between POI and CVD utilizing the method of Mendelian randomization (MR). MR analyses utilized summary statistics from the most extensive genome-wide association studies (GWAS) on POI and CVD extracted from European ancestry cohorts and the FinnGen biobank. The inverse variance-weighted (IVW) method was the primary MR analysis technique. Supplementary analyses were performed using MR-Robust Adjusted Profile Score (MR-RAPS). Cochran's Q statistic, MR-Egger, and weighted median MR models were employed to further assess heterogeneity and horizontal pleiotropy. Causal effects of POI on coronary heart disease (odds ratio [OR] = 1.048, 95% confidence interval [CI]: 1.006-1.091; = 0.023)] and ischemic stroke (OR = 1.010, 95% CI: 1.000-1.020; = 0.0498) were found. However, we did not observe a significant correlation between POI and hypertension (OR = 0.999, 95% CI: 0.994-1.004, p = 0.691), heart failure (OR = 1.009, 95% CI: 0.999-1.020, p = 0.0725), atrial fibrillation (OR = 0.995, 95% CI: 0.986-1.004, p = 0.3035), and myocardial infarction (OR = 1.002, 95% CI: 0.991-1.013, p = 0.7061). POI was causally associated with coronary heart disease and ischemic stroke, with no apparent impact on hypertension, heart failure, atrial fibrillation, or myocardial infarction. The causal relationship between POI and CVD underscores the imperative for proactive cardiovascular risk management in individuals with POI.
迄今为止,前瞻性研究仍缺乏对早发性卵巢功能不全(POI)与心血管疾病(CVD)之间关联的探究。本研究的目的是利用孟德尔随机化(MR)方法调查POI与CVD之间的潜在关联。MR分析使用了从欧洲血统队列和芬兰基因生物库中提取的关于POI和CVD的最广泛的全基因组关联研究(GWAS)的汇总统计数据。逆方差加权(IVW)方法是主要的MR分析技术。使用MR稳健调整轮廓评分(MR-RAPS)进行补充分析。采用Cochran's Q统计量、MR-Egger和加权中位数MR模型进一步评估异质性和水平多效性。发现POI对冠心病(优势比[OR]=1.048,95%置信区间[CI]:1.006-1.091;P=0.023)和缺血性中风(OR=1.010,95%CI:1.000-1.020;P=0.0498)有因果效应。然而,我们未观察到POI与高血压(OR=0.999,95%CI:0.994-1.004,P=0.691)、心力衰竭(OR=1.009,95%CI:0.999-1.020,P=0.0725)、心房颤动(OR=0.995,95%CI:0.986-1.004,P=0.3035)和心肌梗死(OR=1.002,95%CI:0.991-1.013,P=0.7061)之间存在显著相关性。POI与冠心病和缺血性中风存在因果关联,对高血压、心力衰竭、心房颤动或心肌梗死无明显影响。POI与CVD之间的因果关系强调了对POI患者进行积极心血管风险管理的必要性。